Genetic Considerations

Susceptibility to alcohol abuse appears to run in families and is the subject of vigorous ongoing investigations to locate genes that contribute. It is probable that the effects of multiple genes and environment are involved in alcoholism. Twin studies have shown a stronger concordance between identical rather than nonidentical twins (55% or greater concordance for monozygotic twins and 28% for same sex dizygotic twins). Genetic differences in alcohol metabolism may result in higher levels of a metabolite that produces pleasure for those with a predisposition toward alcohol abuse.

GENDER, ETHNIC/RACIAL, AND LIFE SPAN CONSIDERATIONS

Acute alcohol intoxication can affect people of any age, gender, race, or socioeconomic background. Alcohol use should be considered when a patient is seen for trauma, acute abdominal pain, cardiac dysrhythmias, cardiomyopathy, encephalopathy, coma, seizures, pancreatitis, sepsis, anxiety, delirium, depression, or suicide attempt.

TEENAGERS AND YOUNG ADULTS. The use of alcohol is seen as a part of growing up for many individuals. Binge drinking is common and dangerous. The combination of alcohol and potentially risky activities, such as driving or sex, is a source of high morbidity and mortality for teens.

PREGNANT WOMEN. Alcohol is a potent teratogen. Binge drinking and moderate to heavy drinking have been associated with many fetal abnormalities. There is no currently known safe drinking level during pregnancy.

ELDERLY. Loss of friends and family, loss of income, decreased mobility, and chronic illness or pain may increase isolation and loneliness and lead to an increased use of alcohol by the elderly.

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